Organization Active NPI

John W. de Roy Chiropractic Corporation

  • Chiropractor
  • San Francisco, CA
National Provider Identifier
1053521898
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15780 Issued in CA
Legal business name
JOHN W. DE ROY CHIROPRACTIC CORPORATION
Practice address
120 Hickory St # B
San Francisco, CA 94102-5908
Phone
(415) 864-7860
Fax
(415) 864-6228
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Warren De Roy, D.C.NPI 1881865418
Title
Owner
Phone
(415) 864-7860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 15780 CA Primary

Addresses

Primary practice location

120 Hickory St # B
San Francisco, CA 94102-5908

Mailing address

120 Hickory St # B
San Francisco, CA 94102-5908
Phone (415) 864-7860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080411000558 CA Part B Supplier - Clinic/Group Practice 5294812467 Receives reassigned benefits from 1 practitioner
Practice locations: San Francisco, CA

National Provider Directory

National Provider Directory

Locations

120 Hickory St
#B
San Francisco, CA 94102
Phone (415) 864-7860

120B Hickory St
San Francisco, CA 94102
Phone (415) 805-6251

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1053521898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HICKORY ST # B",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941025908",
            "telephone_number": "415-864-7860",
            "fax_number": "415-864-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HICKORY ST # B",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941025908",
            "telephone_number": "415-864-7860",
            "fax_number": "415-864-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN W. DE ROY CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "DE ROY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-864-7860",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "15780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.